Five Years Inn, No. 1

A word to the wise regarding scans amid Covid

Welcome to the very first newsletter entry! I am so excited to roll out Five Years Inn, a place for people who have survived cancer and want to stay that way to meet, greet and share best ideas.

My own experience with Stage 3 breast cancer serves as the basis for this newsletter about living beyond cancer treatment. I was diagnosed with an invasive form of breast cancer in 2016. With the help of some incredible doctors and my amazing husband and family, I made it through. I am lucky and I know it. But, let’s face it, once you’ve travelled this road it’s never very far from your thoughts. My doctors told me that once the mastectomy was completed, I was technically “cancer free.” I didn’t feel that way. In fact, I found myself secretly bracing myself for a reoccurrence. Strangely, many people assume that former patients are racing for a goal line, kind of like in football. If you make it five years, they believe, then, you can say you are clear. People are constantly asking me if I have hit that milestone. And, that’s why I am calling the newsletter, “Five Years Inn.” I wanted a place to talk with people who are on the same journey, recovered and trying to stay that way.

Join me on these pages to share the best ideas, practices and inspiration for people who have beaten life-threatening disease and are still working on continued recovery and preventing a recurrence. The newsletter will cover a broad array of topics, including health and medical concerns, medical innovation, food, exercise and the mental stresses, anxiety and worry and how to deal with them. I also plan to write about the soft topics that make life better for cancer survivors. (Expect my toy poodle, Rufus to make an appearance!) To be sure, I am no doctor or health professional, I am simply someone on the search for answers. I hope others might come along on my quest. Here’s my first entry.

I set up this newsletter to write about life after cancer, but there is a health threat right now that transcends the difficulty of your post-cancer life – that’s the difficulty of getting diagnosed in the first place. These days, patients are shunning hospitals and even their own doctors’ offices because of fear of getting Covid 19. My own cancer surgeon, Dr. Monica Morrow, the head of breast surgery at Memorial Sloan Kettering, told me that even the world’s most respected healthcare institutions have been stigmatized by their association with the pandemic. People are literally afraid to go to the doctor for cancer screenings for fear of contracting Covid 19.

Let’s be clear here. Contracting Covid 19, while a horrible disease, is simply not likely to kill you unless you have specific preconditions or are elderly. The statistics thrown around in the media are often misleading or flat out wrong. Take the most-cited stat, the case fatality rate, calculated as the number of Covid deaths divided by total confirmed cases multiplied by 100. Truth is we really don’t know for sure how many people have gotten Covid because so many people show no symptoms. Did your 20-year-old neighbor get diagnosed when he was under the weather one afternoon? Likely not. The infection fatality rate figures are compromised for the same reason. What we do know and can say without equivocation is that the older you are the more likely you care to die from Covid. Having heart disease, obesity, asthma or any of a host of preconditions also figures prominently in fatal Covid cases. Even so, the worst effects of the disease are largely avoidable with simple precautions, like wearing a mask and social distancing. So, if you have been lucky enough to shelter in place and work from home, your likelihood of dying from Covid is not high. Plus, now that the vaccine is available, even those in compromised situations are less likely to get sick.

  There is no vaccine for cancer. Not yet. If you’re using the pandemic as an excuse to duck a screen or truly fear the doctors’ office, I understand, but am not sympathetic. The disease is on track to eclipse heart disease as the nation’s number one killer. Look, some people may be betting that waiting a year or two for your scan is no big deal. I know what you are thinking. Cancer is a slow killer.

But that assumption is simply not true. I can tell you because I developed a virulent and fast-moving stage three lobular breast cancer six months after a mammogram. Just six months after my scan came back clear, the nipple on my right breast inverted, a classic sign of breast cancer. That was just six months later, not 12 months, or even 18 months later. The good news is that I had a physical manifestation of the disease because otherwise I might have done nothing, waiting another six months or longer for another scan. And, by that time, who knows what I might have faced.

Last year this time, screenings nationwide were down 85 percent for breast cancer, 75 percent for colon cancer and 74 percent for prostate cancer, according to the American Cancer Society. And the problem is not getting all that much better. Between March and June 22 million screenings were missed across the country.

 The impacts of this lack of baseline, fundamental care will dog us for decades to come. The science is clear. Skipping even one mammogram before getting a positive breast cancer diagnosis results in a significantly higher risk of dying from breast cancer, according to a recent study in the medial journal, Radiology.  

Privately, health care professionals are discussing whether Covid-19 has derailed the fight against cancer. The progress we have made has been enormous. Over the last 25 years, cancer death rates are down 25 percent largely because of screening tools like mammograms and colonoscopies, which allowed for early detection and action. The delays in screening forced by the pandemic mean there will be more – more malignant tumors, advanced stages of cancer and possibly death. Now, medical professionals predict deaths from cancer will rise significantly. By 2025, 10 percent more women will die from breast cancer, 15 percent more people will die from colorectal cancer and 5 percent more will die from lung cancer.

 It doesn’t have to be that way. We can take steps to protect our own health. Covid 19 is not the only threat.  And, for most of us, it’s not the worst threat.